乙型肝炎病毒父婴传播的免疫预防研究

Immune Prevention of HBV Transmission from Father to Infant

目的探讨乙型肝炎病毒(hepatitis Bvirus,HBV)父婴传播的免疫预防。方法选择父亲为HBV携带者而母亲无任何HBV感染标志的新生儿为研究对象,检测新生儿的HBV感染标志并分析父亲与婴儿所携HBVS基因同源性,对受染新生儿实施免疫预防方案,1年后检测HBV表面抗体并评价免疫效果。结果16例婴儿出生时在脐带血中检测出HBV感染标志。对父亲与婴儿所携HBVS基因第451～660位核苷酸进行序列分析,同源性在98～100%之间,并检出488、491、494、530、546、581位核苷酸变异导致112、113、114、126、131、143位氨基酸替代。随访10名婴儿,9名在实施免疫预防后1年HBV表面抗体阳转,其中126位氨基酸变异株感染的2名婴儿HBV表面抗体滴度低且同时可检出表面抗原。结论存在HBV的父婴传播途径;免疫预防后受染子代表面抗体阳转率为90%,感染HBV126位氨基酸变异株的子代保护性抗体低下。

Objective To study the immune prevention of hepatitis B virus （HBV） transmission from father to infant.Methods Sixteen infants were studied.Their fathers were HBV carriers,and their mothers had no HBV infection.The infants infected HBV in the womb.The homogenous of HBV S gene for the fathers and infants were compared.HBV vaccine and HBIG were injected for the infants after their birth.After 1 year,5 serum markers for HBV were detected.Results The homogenous of HBV S gene were 98%~100% in fathers and infants.The mutation of 488,491,494,530,546,581 nucleotide of S gene caused substitution in 112,113,114,126,131,143 amino acid.Ten infants were visited after 1 year.The anti-HBs were positive in 9 infants.The anti-HBs and HBsAg were detected in 2 infants who infected HBV with mutation in 126 amino acid of the S gene.Conclusion There existed HBV transmission from father to infant.The anti-HBs could be detected in 90% infants after the immune prevention.The levels of anti-HBs in the infants infected HBV in 126 main mutation strains were low.